Provider Demographics
NPI:1972164119
Name:NORTHERN VIRGINIA SENIOR CAREGIVERS CO
Entity type:Organization
Organization Name:NORTHERN VIRGINIA SENIOR CAREGIVERS CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-258-0111
Mailing Address - Street 1:PO BOX 1700
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20177-1700
Mailing Address - Country:US
Mailing Address - Phone:540-409-4401
Mailing Address - Fax:571-258-0112
Practice Address - Street 1:158 FRONT ROYAL PIKE STE 103
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4324
Practice Address - Country:US
Practice Address - Phone:540-409-4401
Practice Address - Fax:571-258-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty